Permit a CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 00100
T I. G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/24/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE# 010
Project: National American University Subdivision: VARNS ACRES Lot: 9
Project Description: Modification of (111) fire sprinkler heads for new tenant.
Contractor: EXPRESS FIRE SYSTEMS INC Owner: TRIANGLE POINTE LLC
1913 41ST STREET 901 NE GLISAN ST, #100
WASHOUGAL, WA 98671 PORTLAND, OR 97232
PHONE: 360 - 953 -8432 PHONE: 503 - 297 -8791
FAX: 360 - 953 -8394
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/03/2012 $134.48
12% State Surcharge - Building 07/03/2012 $16.14
Type of Use: COM Plan Review - Fire Life Safety - COM 07/03/2012 $53.79
Class of Work: ALT Type of Const: Info Process /Archiving - Lg $2.00 (over 07/03/2012 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process /Archiving - Sm $0.50 (up to 07/03/2012 $3.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard:
Density: 0 Design Area: 0
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $209.41
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $5,937.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started wi ii 180 days of
issuance . is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ad•pte by the Oregon
Utili otification Cente . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1: •0. You may obtai a opy of the rules
or irect questions to OUNC • calling 503.232.1987 or 1.800.332.2344.
ssued By: \ _ S / / Permittee Signature: ,
G■f.
Call 503.639.4175 by 7:00 a.m. for the next available inspect,' date. r
This permit card shall be kept in a conspicuous place on the job site until completion of the proj _ t.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System r. _ Pi' FOR OFFICE USE ()NIA
City of Tigard Received
ism Permit No.: ,rps42B,! ?_��t)!1)
° 13125 SW Hall Blvd., Tigard, OR 97223 JUL 212 Dateiv 3 Plan Review `��l 7
Phone: 503.718.2439 Fax: 503.598.1960 DDate/By: {�/ ' / ( 17 �� Other Permit:
.
��iJI � Date Read B / Suris: S See Pa e 2 for
T I G n k D Inspection Line: 503 v y y : ;i. g
Internet: www.tigard- or.gov Notified/M �� Supplemental Information
D IVISION —5,10A w /i
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling Valuation: $
® Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13333 SW 68 Parkway New dwelling area: square feet
City /State /ZIP: Tigard, OR 97228 Garage /carport area: square feet
Suite/bldg. /apt. no.: Garden Project name: National American Univers Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Relocate 111 Sprinklers due to new Ceiling layout Valuation: 555,937.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing: Light Hazard
Phone: ( ) Fax: ( ) New: Light Hazard
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: Express Fire Systems, Inc. (Please refer to fee schedule)
Permit fee:
Address: 1913 41 Street
State surcharge (12% of permit fee):
City /State /ZIP: Washougal, WA 98671 a
FLS plan review (40% of permit fee):
Phone: (360) 953 -8432 Fax: (360) 953 -8394 (Due upon application.)
l lie.: 193272 '3\ \ t / Total permit fees: 411/ \ Amount received: PI.
Authorized signature: tV /id
' `
This permit application expires if a permit is not obtained
Print name: Pattie Wenholz Date: 06 - - within 180 days after it has been accepted as complete.
• Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits \FPS- PermitApp.doe Rev 01 /05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition El 1 -10 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 111
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet El Dry
Additional Standpipes N/A
Information: Hazard Group Light Hazard
Density N/A
Design Area N/A
K. Factor 5.6 QR
Sprinkler Project Valuation: _ $ 5937
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
_ 7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
E: \Express \ Jobs \S12 -032 National American University \Tigard City Fire Protection stem- PermitApp.doc Rev 01/05/2012